Under the hood, async/await is using callbacks into a finite state machine. JS Promise and C# Task<T> (which are very similar in design, for obvious reasons) are both still driving the operations in an async/await function, the JS runtime, C# compiler (or TS compiler), is doing the heavy lifting of converting imperative looking code into a finite state machine for Promise/Task callbacks.

You can't avoid callbacks in an asynchronous flow. async/await is just a conversion between imperative looking code and a callback structure. It's a great win for developers that we've built such conversion tools (thanks to work on monads in languages like Haskell and OCaml).

Rx is for higher-order asynchronous streams where you have multiple events over time. It doesn't have the beauty of async/await because it's a much more complicated abstraction than the basic monad of Promise/Task. If you have a stream of events over time you can use Rx and if you have just one Promise at a time you can use Promise/Task and thus async/await. (The difference between I want to know every click of this button and I want to know just the next click of this button.) Most applications are a little bit of column A and a little bit of column B, and you don't have to pick one or the other, you can use both side-by-side.